45 CFR § 180 compliance
D · 65
This hospital published part of what § 180 requires.
●Machine-readable file published
●Gross / standard charges
●Discounted cash price
○Payer-specific negotiated rates
○Min / max negotiated charges
●Free, public, no login required
Procedures listed
1,011
Insurances with rates
0
CPT / HCPCS codes
988
Source MRF
Most expensive procedures (gross)
J2997
$36,136
ALTEPLASE (ACTIVASE) 100 MG VIAL
Gross
$36,136
J3101
$19,299
TENECTEPLASE (TNKASE) 50 MG VIAL
Gross
$19,299
J2505
$18,854
PEGFILGRASTIM (NEULASTA)6 MG/0.6 ML INJ*
Gross
$18,854
J9217
$15,536
LEUPROLIDE ACET (LUPRON DEPOT) 22.5 MG**
Gross
$15,536
259
$9,436
FACTOR VIII
Gross
$9,436
J0717
$8,846
CERTOLIZUMAB (CIMZIA) 200mg/vial: 2 vial
Gross
$8,846
J7168
$6,496
PCC (KCENTRA) ~ 500 UNITS INJ
Gross
$6,496
J0897
$6,376
DENOSUMAB (PROLIA) 60 MG INJ
Gross
$6,376
J0840
$5,373
ANTIVENOM ( CROFAB) VIAL
Gross
$5,373
74174
$5,290
CT CTA ABDOMEN PELVIS
Gross
$5,290
74178
$5,076
CT ABDOMEN PELVIS W AND WO CONTRAST
Gross
$5,076
74177
$4,890
CT ABDOMEN PELVIS W CONTRAST
Gross
$4,890
J0882
$4,742
DARBEPOETIN (ARANESP) 300 mcg/0.6 mL *
Gross
$4,742
59409
$4,171
OB DELIVERY FEE
Gross
$4,171
74176
$4,150
CT ABDOMEN PELVIS WO CONTRAST
Gross
$4,150
75635
$3,965
CT CTA RUNOFF
Gross
$3,965
71275
$3,558
CT CTA CHEST
Gross
$3,558
13100
$3,422
REPAIR COMPL TRUNK 1.1-2.5 CM
Gross
$3,422
12057
$3,369
REPAIR INTERM F E N >30.0 CM
Gross
$3,369
74170
$3,309
CT UPPER ABDOMEN W AND WO CONTRAST
Gross
$3,309
90376
$3,302
RABIES IMMUNGLOB-HUMAN- 150IU/ML 2ML
Gross
$3,302
90375
$3,302
RABIES IMMUNGLOB (HyperRab) 300 IU/ML
Gross
$3,302
70496
$3,275
CT CTA C.O.W CIRCLE OF WILLIS
Gross
$3,275
70498
$3,231
CT CTA CAROTID
Gross
$3,231
13152
$3,106
REPAIR COMPL L N E 2.6-7.5 CM
Gross
$3,106
93975
$3,061
US RETROPERITONEAL IN/OUT FLOW COMPLETE
Gross
$3,061
93925
$3,007
US ARTERIES LOWER EXT BILATERAL
Gross
$3,007
71270
$2,887
CT CHEST WITH AND WO CONTRAST
Gross
$2,887
J1439
$2,859
FERRIC CARBOXYMAL. (INJECTAFER) 50MG/ML*
Gross
$2,859
74160
$2,857
CT UPPER ABDOMEN W CONTRAST
Gross
$2,857
93271
$2,767
EXTERNAL EVENT MONITOR RECORDING
Gross
$2,767
71260
$2,732
CT CHEST W CONTRAST
Gross
$2,732
72128
$2,705
CT THORACIC WO CONTRAST
Gross
$2,705
72125
$2,685
CT CERVICAL SPINE WO CONTRAST
Gross
$2,685
72192
$2,588
CT PELVIS WO CONTRAST
Gross
$2,588
70480
$2,471
CT MAST/TEMP/IAC W/O CONTRAST
Gross
$2,471
13132
$2,455
REPAIR COMPL F C C N 2.6-7.5 CM
Gross
$2,455
73700
$2,453
CT LOWER EXTREM WO CONTRAST RIGHT FX,Right Side
Gross
$2,453
93306
$2,453
US CARDIAC ECHO COMPLETE W/COLOR
Gross
$2,453
70481
$2,448
CT MAST/TEMP/IAC W CONTRAST
Gross
$2,448
72131
$2,435
CT LUMBAR SPINE WO CONTRAST
Gross
$2,435
71250
$2,403
CT CHEST WO CONTRAST
Gross
$2,403
74150
$2,345
CT UPPER ABDOMEN WO CONTRAST
Gross
$2,345
31605
$2,322
CRICOTHYROTOMY
Gross
$2,322
93350
$2,287
US CARDIAC STRESS ECHO
Gross
$2,287
G0390
$2,278
TRAUMA RESPONSE TEAM
Gross
$2,278
120
$2,233
ROOM CHARGE ACUTE SEMI - PRIVATE
Gross
$2,233
70470
$2,229
CT HEAD WO AND W CONTRAST
Gross
$2,229
93880
$2,211
US CAROTID DUPLEX BILATERAL
Gross
$2,211
93970
$2,211
US VENOUS EXTREMITIES - COMPLETE
Gross
$2,211
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J2997 | ALTEPLASE (ACTIVASE) 100 MG VIAL | $36,136 | $36,136 | — | — | 0 |
| J3101 | TENECTEPLASE (TNKASE) 50 MG VIAL | $19,299 | $19,299 | — | — | 0 |
| J2505 | PEGFILGRASTIM (NEULASTA)6 MG/0.6 ML INJ* | $18,854 | $18,854 | — | — | 0 |
| J9217 | LEUPROLIDE ACET (LUPRON DEPOT) 22.5 MG** | $15,536 | $15,536 | — | — | 0 |
| 259 | FACTOR VIII | $9,436 | $9,436 | — | — | 0 |
| J0717 | CERTOLIZUMAB (CIMZIA) 200mg/vial: 2 vial | $8,846 | $8,846 | — | — | 0 |
| J7168 | PCC (KCENTRA) ~ 500 UNITS INJ | $6,496 | $6,496 | — | — | 0 |
| J0897 | DENOSUMAB (PROLIA) 60 MG INJ | $6,376 | $6,376 | — | — | 0 |
| J0840 | ANTIVENOM ( CROFAB) VIAL | $5,373 | $5,373 | — | — | 0 |
| 74174 | CT CTA ABDOMEN PELVIS | $5,290 | $5,290 | — | — | 0 |
| 74178 | CT ABDOMEN PELVIS W AND WO CONTRAST | $5,076 | $5,076 | — | — | 0 |
| 74177 | CT ABDOMEN PELVIS W CONTRAST | $4,890 | $4,890 | — | — | 0 |
| J0882 | DARBEPOETIN (ARANESP) 300 mcg/0.6 mL * | $4,742 | $4,742 | — | — | 0 |
| 59409 | OB DELIVERY FEE | $4,171 | $4,171 | — | — | 0 |
| 74176 | CT ABDOMEN PELVIS WO CONTRAST | $4,150 | $4,150 | — | — | 0 |
| 75635 | CT CTA RUNOFF | $3,965 | $3,965 | — | — | 0 |
| 71275 | CT CTA CHEST | $3,558 | $3,558 | — | — | 0 |
| 13100 | REPAIR COMPL TRUNK 1.1-2.5 CM | $3,422 | $3,422 | — | — | 0 |
| 12057 | REPAIR INTERM F E N >30.0 CM | $3,369 | $3,369 | — | — | 0 |
| 74170 | CT UPPER ABDOMEN W AND WO CONTRAST | $3,309 | $3,309 | — | — | 0 |
| 90376 | RABIES IMMUNGLOB-HUMAN- 150IU/ML 2ML | $3,302 | $3,302 | — | — | 0 |
| 90375 | RABIES IMMUNGLOB (HyperRab) 300 IU/ML | $3,302 | $3,302 | — | — | 0 |
| 70496 | CT CTA C.O.W CIRCLE OF WILLIS | $3,275 | $3,275 | — | — | 0 |
| 70498 | CT CTA CAROTID | $3,231 | $3,231 | — | — | 0 |
| 13152 | REPAIR COMPL L N E 2.6-7.5 CM | $3,106 | $3,106 | — | — | 0 |
| 93975 | US RETROPERITONEAL IN/OUT FLOW COMPLETE | $3,061 | $3,061 | — | — | 0 |
| 93925 | US ARTERIES LOWER EXT BILATERAL | $3,007 | $3,007 | — | — | 0 |
| 71270 | CT CHEST WITH AND WO CONTRAST | $2,887 | $2,887 | — | — | 0 |
| J1439 | FERRIC CARBOXYMAL. (INJECTAFER) 50MG/ML* | $2,859 | $2,859 | — | — | 0 |
| 74160 | CT UPPER ABDOMEN W CONTRAST | $2,857 | $2,857 | — | — | 0 |
| 93271 | EXTERNAL EVENT MONITOR RECORDING | $2,767 | $2,767 | — | — | 0 |
| 71260 | CT CHEST W CONTRAST | $2,732 | $2,732 | — | — | 0 |
| 72128 | CT THORACIC WO CONTRAST | $2,705 | $2,705 | — | — | 0 |
| 72125 | CT CERVICAL SPINE WO CONTRAST | $2,685 | $2,685 | — | — | 0 |
| 72192 | CT PELVIS WO CONTRAST | $2,588 | $2,588 | — | — | 0 |
| 70480 | CT MAST/TEMP/IAC W/O CONTRAST | $2,471 | $2,471 | — | — | 0 |
| 13132 | REPAIR COMPL F C C N 2.6-7.5 CM | $2,455 | $2,455 | — | — | 0 |
| 73700 | CT LOWER EXTREM WO CONTRAST RIGHT FX,Right Side | $2,453 | $2,453 | — | — | 0 |
| 93306 | US CARDIAC ECHO COMPLETE W/COLOR | $2,453 | $2,453 | — | — | 0 |
| 70481 | CT MAST/TEMP/IAC W CONTRAST | $2,448 | $2,448 | — | — | 0 |
| 72131 | CT LUMBAR SPINE WO CONTRAST | $2,435 | $2,435 | — | — | 0 |
| 71250 | CT CHEST WO CONTRAST | $2,403 | $2,403 | — | — | 0 |
| 74150 | CT UPPER ABDOMEN WO CONTRAST | $2,345 | $2,345 | — | — | 0 |
| 31605 | CRICOTHYROTOMY | $2,322 | $2,322 | — | — | 0 |
| 93350 | US CARDIAC STRESS ECHO | $2,287 | $2,287 | — | — | 0 |
| G0390 | TRAUMA RESPONSE TEAM | $2,278 | $2,278 | — | — | 0 |
| 120 | ROOM CHARGE ACUTE SEMI - PRIVATE | $2,233 | $2,233 | — | — | 0 |
| 70470 | CT HEAD WO AND W CONTRAST | $2,229 | $2,229 | — | — | 0 |
| 93880 | US CAROTID DUPLEX BILATERAL | $2,211 | $2,211 | — | — | 0 |
| 93970 | US VENOUS EXTREMITIES - COMPLETE | $2,211 | $2,211 | — | — | 0 |
Showing top 50 of 1,011 priced procedures, sorted by gross charge.
Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.